** Update on February 22, 2014:
**1) I have a renewed sense of faith in gluteal specific strengthening exercises. I have gotten relief from more than just PS by doing regular glute strengthening work. For runners especially, I think these exercises are a staple in the battle to remain injury free. I do clam shells (see video in original post below), side leg lifts, hip hikes and wall pushes (described in this article). I try to do these daily. Patience is the key. I just came out the other side of IT band syndrome by doing these exercises, but it took four weeks doing these four exercises daily to start to see a difference.
2) This is a problem that tends to hang on and rest is not necessarily going to make it go away. In fact, I have not met a single person suffering from this problem who was able to get rid of it solely by taking a break from running.
3) The key to treating this seems to be getting some sort of manipulative therapy like Active Release Therapy (ART) from a qualified practitioner. A good massage therapist can help here too, but they need to be able to get in to the hip capsule if your problem is originating there. This is a deep, deep place in your pelvic region that may make you blush when they go after it.
4) If you have adhesions in your hip and butt region (glute min/max, TFL, deeper butt muscles), your best friend should be a lacrosse ball. Not a tennis ball. Not a golf ball. A lacrosse ball. You should roll out the sore spots in your gluteal and hip flexor region in every possible direction with that ball: laying down, standing up against a wall, however you can get in there and break down the adhesions that are messing things up.
5) Be Patient and don't expect instant relief. It took me months of self treatment, following 5 days of intense ART, to get this problem to finally
6) Sitting is the devil when it comes to PS. I have been using a standing desk for about 10 months now and believe this is part of the reason I am free from hamstring/piriformis trouble. Aside from getting a sports massage once every 3-4 weeks, I now do nothing else. No stretching. No foam rolling. No lacrosse ball rolling. As long as I don't sit for a long time. I start to feel piriformis niggles when I have been sitting a lot, usually driving long distances since I don't sit at a desk for very long. Standing desks are cheap. I got mine at Ikea for less than $100. It's a table top with some long legs attached. Basic and beautiful.
Now back to our regularly scheduled program...
The original post:
A friend of mine, who also happens to be a Physical Therapist, sent me the links to a couple of YouTube videos yesterday. In one of the videos (for ballerinas), a woman demonstrates the clam shell exercise designed to target a few of the muscles in the butt that can cause what's known as piriformis syndrome. I have done this move before, but, after watching this woman demonstrate the right and wrong way to do it, I realized I had been doing it all wrong before. The key appears to be in isolating the butt muscles and not allowing your quads and abductor to take over like they typically like to do. It is such a slight movement, but when done right, burns the bejesus out of your butt. The ballerina also demonstrates how to stretch the piriformis, though I pretty much have that dialed. She also sent me a link to a basic abductor exercise.
Serendipity graced me with her presence during my YouTube visit, for I found a gentleman with a video entitled How to Fix Piriformis Syndrome listed in the "you might also like" section. The dude is a goofball and appears to be filming this in a hotel room, but I'll be damned if he didn't have something good to share. He demonstrates a little exercise that is an example of "neural flossing". He says it is supposed to loosen the muscles along the length of the sciatic nerve. I don't really buy his explanation for how it works, but I decided it was worth a try. I actually felt a difference after doing it for the first time. I also found a better explanation for neural flossing here.
After introducing these new stretches and exercises to my routine yesterday, my right leg felt so much stronger, albeit a little tortured, when I started my long run today. I had 16 miles to conquer with 9 miles of pace work. The 9 miles included:
3 x 3 miles alternating 10k effort and goal marathon pace every 400m without stopping during the 3-mile repeat, 3-5 minute jog rests between each 3-mile repeat.
I started my run at 9:48 and 75 degrees. Yes, of course I would have loved to have started in the cool morning air, but I had an even stronger desire to get my beauty sleep this morning. I started the workout on the track, since that's what my training plan called for. However, I knew by the end of the first 3-mile block, that I needed to do the rest of this baby in the shade of trees. The track was scorching hot. So, I jogged over to a shady section of the American River Bike trail and ran the rest of the workout back and forth there. It was a busy morning on the trail as I dodged bikers, runners and small mammals the entire time. But, being in the shade was priceless.
My paces averaged 5:56 for the 10k effort and 6:12 for the goal marathon pace for an overall average for the 9 miles of 6:04 pace. I was happy with how I felt and even happier that I felt absolutely no tightness or pain in my right leg. Thank you Elissa and the odd dude filming himself in the hotel room. I'll keep you posted on my progress with these exercises and my butt/hip/hamstring issue.
This was a 94-mile week and felt like nothing. I guess I have 6 more miles to run tonight to complete the 94, but I have a feeling that will go well too. I believe I am feeling the benefit of increased iron in my body and higher vitamin D levels. I got my test results back on my vitamin D levels yesterday and they have doubled (from 47 to 92 ng/ml) since April when I last had them checked!
I have a key tough workout coming up next week (Yasso 800s on Tuesday) followed by a 10-mile race next Sunday. While I'm still running high mileage (86 miles) next week, so won't be primed for a super fast race at that distance, it's the same mileage I was running last year when I ran this race. So, it will be another good comparison for me on my road to Chicago.